BIG Medicine Magazine™

MEDICINE MAGAZINE™ The Magazine for Big Thinkers

Are you working harder for LESS MONEY? Livingon In Living An an ISLAND PARADISE E H D T O O Practice W Y L Leadership L IT’S IN THE POSE! HO SSUE

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$9.95

Letter From The Editor

Plastic Lives.

Plastic Surgery Knives.

Angela O’Mara Editor-In-Chief Founder

That’s what many people think of Hollywood. Not me. I was raised watching beauties such as Elizabeth Taylor, Grace Kelly and Audrey Hepburn, and handsome men such as Cary Grant, John Wayne and Humphrey Bogart. Hollywood celebrity of the 50s was new and fresh. It embodied youth, virility, glamour and opportunity. There appeared to be an innocence in the old Hollywood that we don’t see today. Yet many of its stars back then suffered similar issues to the celebrities of today. Medicine during that time, also was fresh and glamorous. Doctors were prestigious, and TV Producers were making shows about them. The same is true today. TV continues to be the most powerful of all media as you will learn on Page 20 America LOVES its DOCTORS! Being on TV and seen in the media spotlight is all well and good. But keeping a hold on fame and managing the fortunes it can bring can be daunting, if not impossible for many doctors. Medical school didn’t exactly teach you how to run a business or how to be a celebrity doctor. I hope this issue helps you get a better understanding of the many opportunities available to you as a doctor. I hope you find this issue to be thought provoking, and that it offers you some insights into success building, and that it helps you see that there is also a life waiting for you outside of the OR. There’s a new movement taking place in medicine and you’re reading about it here, for the first time, at BIG Medicine Magazine™ – The Magazine For BIG Thinkers.

Enjoy!

MEDICINE MAGAZINE™ The Magazine for Big Thinkers

www.bigmedicinemagazine.com

BIG Medicine Magazine™

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T able of Contents

MEDICINE MAGAZINE™ The Magazine for Big Thinkers

Editor-In-Chief Angela O’Mara Copy Editor Brandon Murphy Barnes Beauty & Grooming Editor Enna Ruiz

6-9 10 - 12 14 - 15

Practice Leadership Employee Relations Having A World Class Practice

Contributing Editor Michael O’Mara Graphic Design Joe Felipe Publisher Giles Raine Tel: 949 768-1051

16 - 17

The Doctors Told Us

18 - 19

Money Equals Mischief

20 - 25

Hooray For Hollywood

24 - 30

Industry Transformers

31

Beauty & Grooming

33 - 35

Power Preparation

37

Contributors

38

When TV Goes Bad

Fax: 949 768-1060 www.bigmedicinemagazine.com info@bigmedicinemagazine.com

Advertising Sales 949 768-1051 All content in this magazine is protected and may not be copied, reprinted or republished without written permission of Publisher.

All rights reserved. BIG Medicine Magazine™ is a Registered Trademark.

“Life is too short not to have fun.”

Let’s hear it for Long Beach, CA plastic surgeon Dr. Marcel Daniels. His dedication to patient care is unsurpassed, and his sense of humor has kept our editorial team laughing. Dr. Daniels was willingly photographed for our special hollywood section

... begins on page 20 4

BIG Medicine Magazine™

tech Implan S… D REWAR hat sing t Purcha ff ! pays o To look youthful, an aging face needs volume in the right places. This means envisioning your outcome, and then using appropriate skills and material to make it happen.

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Are YOU Working HARDER For LESS Money?

The New Economy of Medicine. By now it is agreed that the economic world has changed.

The common theme amongst doctors (and, understandably, the rest of the planet) is that they are working harder and for less than sufficient dollars. There is no doubt that as a people we are living a faster paced lifestyle, and that there are more choices available to patients thanks to the amount of content and information available on the Internet. Let’s face it people expect VALUE as well as excellent care from their health care provider whether for an elective procedure or a medical emergency. The late great master of self-help books, Stephen Covey who authored The Seven Habits of Highly Effective People can teach us a thing or two about working SMARTER rather than HARDER. This book has sold more than 25 million copies in 38 languages worldwide, and the audio version has sold 1.5 million copies, and remains one of the world’s best-selling nonfiction books.

So what are those seven habits?

•

Be proactive

•

Begin with the end in mind

•

Put first things first

• Think WIN-WIN •

Seek first to understand, then to be understood

•

Synergize

•

Sharpen the saw - Self Renewal

For more information go to www.stephencovey.com

Set Your Ship To Sail Navigating The New Economy

Is itit time time for foryou youtototake takefleet fleetand andset setsail? sail?

Once you make choice that want to build A Successful Is Once you make thethe choice that youyou want to build A Successful World Class Medical Practice you are embarking on a life changing journey and you must prepare.

When Sir World Class Medical Practice you are embarking on a life changing journey and you must prepare.

Edmund Hillary, who was the first man officially recorded to climb Mount Everest in 1953, made the decision When Sir Edmund Hillary, who was the first man officially recorded to climb Mount Everest in 1953, made the to embark that potentially treacherous climb, theclimb, first thing he did was his sea passage to Bombay. decision toon embark on that potentially treacherous the first thing hebook did was book his sea passage to Bombay.

With clear his vision and thetomeans to help him his destination set inhe place, then training started With his vision andclear the means help him reach hisreach destination set in place, then he started training and mastering his climbing other mountains in preparation for thefeat grand feat of Everest.

As and mastering his climbing skills on skills otheron mountains in preparation for the grand of Everest.

As master master YOUR craft, you must ask yourself: of YOURofcraft, you must ask yourself: • • • • • •

Where am I headed?

Who is on this journey with me?

How do I need to prepare myself and my team for this journey?

What do I need to bring with me?

What problems might I encounter along the way?

Is this truly the journey that I want?

If you can’t answer these questions, DON’T climb on board the ship, or attempt to scale the mountain, until you can.

Self-help books are read by many. If you are in need of a book that can help you understand them further, try try reading reading Revelations Revelations of ofYour YourSelf SelfHelp HelpBooks Book authored Secrets

by Lancaster a practicing This book is aThis realbook journey inner workings authored

by Adams, Lancaster Adams, a doctor. practicing doctor. is ainto realthe journey into the of theworkings brain. Toof read www.sbpra.com/lancasteradams. inner the more brain.go To to read more go to www.sbpra.com/lancasteradams.

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BIG Medicine Magazine™

How Clearly Can You See? Take Our FUTURE Vision Test!

•

Where will you be this time NEXT year, or in 10 years?

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What will your practice/personal life look like?

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Remember that first week back in the office after the New Year? How was it? What is your staff doing? What type of cases did you have?

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Now project how you want it to be AFTER the next New Year celebration

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What kind of year are you looking at?

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What/who have you surrounded yourself with?

REMEMBER: This is YOUR vision. Nobody sees what YOU see. Make it as big and colorful as you like. Write it down. Sleep on it. Go back to it and perfect it to exactly what you want.

Once you see it, you can have it!

What Might YOUR Vision Be? For those wondering where to start on Vision Building, here are some BIG suggestions!

VISION •

100% elective surgery practice by

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Add a medi-spa, product line or wellness center to your practice

(choose a date that suits you)

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Escape to a deserted island more often

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Have multiple practice locations

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To earn $10+ million dollars this year

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Bring your practice back to where it was pre-recession

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Bring in an associate so you can expand your practice

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Bring in an associate so you can spend more time with family and friends

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Patent an invention you are working on outside of the practice

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Develop your own skin care or vitamin line

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Live the life you deserve

“Follow an old path and you will find the expected. Blaze a new trail and you will will have have an an adventure,” adventure.” Anonymous.

Anonymous you BIG Medicine Magazine™

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What’s YOUR Current Practice Reality?

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Take your own temperature – self-diagnosis can go a long way

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Don’t hide the truth

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If a staff member is not up to par, cut them loose. You deserve a good crew

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Does your office need an upgrade?

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What is your financial status?

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Are you doing the surgeries you really want to be doing?

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Is your office location ideal?

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Are you in the kind of physical condition you want to be in?

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How much time do you spend outside of the practice?

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Are you doing the things you LOVE to do?

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Are you happy?

IfIf you need further help with understanding your own current reality, try the BIG Medicine Magazine™ Practice you need further help with understanding your own current reality, try the BIG Medicine Magazine™ Practice assessment tool called The GAP. You can access The . You can access The GAP FREE at www.bigmedicinemagazine.com/bigstrategy.

FREE at www.bigmedicinemagazine.com/bigstrategy assessment tool called The

Write YOUR OWN Prescription For Success TODAY! Developing a PRACTICE STRATEGY can be likened to an architect creating a detailed blueprint and then watching as the house is built to completion. Here are a few areas for review before you put ink to paper.

Step 1.

Step 2.

• Set 30, 60 and 90 day achievable goals

• Make a commitment and schedule for practice building and future planning time

• Help your staff with accountability – require them to provide you with Weekly Action Plans • Take a long hard look at your financial needs over the next 12 months • Review practice growth opportunities • What is your current and future staffing requirement?

• Do you have complete and clear job descriptions and role designations for all staff members?

• Have you set a realistic budget?

• Set new patient acquisition goals • Project future product sales objectives and set sales goals • Set time aside for creative time • Set time aside for Golf Time (or leisure activity of choice) Step 3.

• Take Action • Take a leap. Not just a leap of faith

It’s important to schedule time to work “on” your practice.

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BIG Medicine Magazine™

Where The Real Money Is YOU AND YOUR HABITS!

Personal habits, relationships, value creation basics and support structure add up to one thing = The Largest Check You Can Handle. BIG Medicine Magazine™ talked with John Davidson, Executive Head Coach and CEO of High Level Performance about how YOU can apply these four areas to your practice to attain optimal success and, yes, make money.

What do you think is the largest check you can earn with the current state of these areas in your life? If you were to increase that average transaction size by 30%, what adjustments do you think you would have to make in each of these areas?

• Personal Habits

• Personal Habits • Support Structure

• Relationships

• Relationships • Value Creation Basics Let’s articulate your “Largest Check” strategy and “The Biggest Check” concept. Over time, as a physician you’ve grown your medical practice by asking certain fees for the medical services you provide. Whether you receive checks from elective patient procedures or from insurance companies, most times you get what you ask for, sometimes you don’t. Your experience is the total sum of all these checks (asking instances) that have occurred since the inception of your career. One recurring characteristic among physicians (and business entrepreneurs) is that they are “locked in” at a certain size check they can obtain consistently. All of your work habits, relationships, support system and the level of value you give patients are equal to the size check you can consistently achieve today in the marketplace. But tomorrow you want a larger check, correct? More income… yes?

Ok, let’s look closely at the 4 areas that can increase that check size: 1. Work Habits.

1. Work Habits. Critical personal behaviors are: a. Always keep your word b. Finish what you begin

c. Be punctual, even early d. Never promise more than you can deliver

2. Relationships: 2. Relationships: Key relationships required: a. You have patient consults/surgery scheduled that will provide income within 90 days? b. You have other pending sources that will provide income that are over 90 days out? i.e., patient consults/bookings in the future, past insurance or other payments that are owed to you c. Do you have a clear plan as to what your next influential step with each area is? d. How intimate are you with your patient’s aspirations, dangers, opportunities, and strengths currently in life? How much range do your conversations have?

3. Support to reach reach and and maintain maintain this this new new size size check? check. How 3. Support System: What systems need to be adjusted, optimized, or implemented to well do you orient your business (practice) around your personal gift (surgical/medical skill)? Is your team (staff) able to support you adequately so that you spend time on your personal gift (surgery/medical skill)? a. How much time are you able to spend on areas where you truly are uniquely skilled? b. How much of the last 7 days did you work in activities that gave you energy? c. What capacity is your support system limiting you to? d. Is your support system uniquely capable of handling all the items you perform excellently, competently, and incompetently? e. How often do you work on their capability to become better at those tasks? Is it hit or miss? Or do you have a set time weekly to devote your energies to build them up? i.e. staff meetings, staff training f. How systematic and consistent is your support system? Does your team have routine actions? g. Are the systems illustrated or written to eliminate questions in the future? h. Do you have staff accountability?

4. Value Creation Basics: How can you build more value with each patient experience and with other relationships that will make a 4. Value difference and increase your net income? a. Not all of your relationships are considered equal b. 5% are responsible for 50% of your current revenue c. What unique process or program do you give your 5%? d. Can they get this total ultimate patient pclient experience anywhere else? e. How much time is spent working ON your unique process?

Are you reacting to a problem, or the outcome of a problem, that organizes your daily practice life? You can either remove problems, or create desired goals, it’s your choice. I can attest that once you begin proactively looking at the four areas described, your ability to become a higher earner will instantly be heightened. The first step is choosing to become the predominant creative force in your life. You’re just seconds from crossing that threshold into new ground, the REAL MONEY is in organizing action from what you love, not from what you need to remove.

BIG Medicine Magazine™

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Enhancing

Employee Relations only known then, what I know now, my life would have been a lot easier”. I certainly don’t feign expertise in employee relations. However, based on the experience of many doctors I have worked with, and my own personal experience running a successful practice, I have developed pearls on hiring and firing.

Dr. Joseph Niamtu If you ask the average medical student what they anticipate as the five greatest challenges in their upcoming career you would, of course, get a list that would include national healthcare, malpractice, wrongful diagnosis, demanding lifestyle sacrifices, etc. If you ask the same question to these people after five years in practice, very high on this list will be a new category and that is employees.

Any seasoned doctor (or business owner) will usually admit that employee relations are one of the biggest challenges of running a business.

Of course here we are talking about the doctor’s office. However, no matter what business you are in, be it a carwash, doughnut shop or surgeon’s office, finding competent, dependable, energized, honest and loyal employees remains a challenge.

A great employee can be an invaluable and cherished asset that can greatly enhance your life, whereas a poor, lackadaisical employee can suck the energy and efficiency away from your practice and life.

Since most doctors generally do not obtain reallife, sophisticated training on staff hiring and firing during medical school, it basically boils down to hit or miss and learning by mistakes; for better or worse. Ask any 20 year veteran of a medical practice about their employee experiences and I guarantee they will tell you “If I would have

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BIG Medicine Magazine™

The first and foremost requirement of having a successful practice with great employees is to have a distinct and clear vision. My vision was to limit my practice to cosmetic facial surgery and market myself as the local expert in cosmetic facial surgery. It also was to have an exemplary and accredited facility with employees committed to teamwork and to have fun at work. My vision included the highest level of patient care and communication. When I hire employees I make my vision clear to them so they understand what is expected. If a practice leader (the doctor) does not have a distinct vision, or if his or her staff is unaware of this vision then chaos results. It would be no different than a football team going to the line without a play.

No player would know what to do. This is why teams have plays and practice them. A leader without a distinct vision is a journey without a map.

I feel that there are eight attributes that make a perfect employee and I learned much of this 30 years ago when I worked closely with a consulting firm called Mercer Global Advisors.

For the sake of measurement, we will refer to a perfect employee as a “10”. What we desire is to be able to screen for employees that are a “7” or above. The following attributes will greatly assist this evaluation process.

1. Competency and Presentation 2. Unconditionally Committed 3. Givers or Takers 4. Offensive or Defensive 5. Superstar or Team Player 6. Joyous 7. Self Managing 8. Learner

1.

Competency and Presentation

Competency is the foremost attribute required in the consideration. Again in any service oriented business, customers or patients expect and seek a certain level of care and service. When a person goes to a nice restaurant, they know in advance that it will be expensive. For that expense they expect a high level of service, i.e. prompt seating, polite treatment, accurate ordering, fast service, and attention to detail.

A waiter that cannot meet those expectations is incompetent. This incompetence will, across the board, cause unhappy customers and eventually harm the reputation of the owner regardless of how great the food was. What is frustrating here is that the restaurant owner may really have paid attention to detail. He may have a beautiful facility with ample parking.

He may purchase only the finest ingredients and he may have hired the best chef in the area. Despite all the attention to detail, a single incompetent employee may shatter his dream of having a fine restaurant by negating his attention to detail. There is a difference between inexperience and incompetence. If our waiter had a badge stating “waiter in training” we may expect a lesser level of service. This employee may become an excellent waiter, but should not be turned loose on the public without someone supervising. Presentation is also a very important factor to consider in the medical business.

This example applies to cosmetic surgery and general medical offices alike.

The discipline of cosmetic surgery involves cosmetics, aesthetics, and health. One of your most powerful marketing principles is the appearance of the doctor and staff. Slovenly, out of shape staff with yellow teeth or fingers from smoking or excessive body piercings are not the image we are trying to convey. An obese employee that is bubbly and neat may be an asset, but someone with cellulite bulging from dingy polyester white scrubs does not assist your marketing efforts. Sorry to be so graphic and judgmental here, but I have honestly been in doctor’s offices with staff that look like the people I have described above. If we are in the health care industry, should we not be exemplifying health?

2. Unconditional Commitment

4. Offensive and Defensive Employees

Unconditionally committed is defined as commitment with the lack of conditions. The closest example I can find is a resident in a training program. As residents, we could not allow anything to take precedence over our work. None of us would have dreamed of telling our respective program chairman that we couldn’t meet a deadline because we ate lunch and didn’t have time. We were in an environment where lunch was not a priority, and our work took precedence. When we are called to the ER in the middle of the night, we can’t say “it’s late, call me in the morning.”

By this categorization we are referring to one’s ability to accept change. Positive change is energy. If you examine successful people and successful practices you will see that they thrive on change. Change should breed excitement, but for many people it breeds fear and insecurity. If a doctor is truly interested in approaching excellence, then they must continually change all aspects of their practice to increase efficiency and service. I challenge and reward my staff for changing. We look at our forms, our policies, our furnishings and so on and brainstorm, as a group, on how to improve every aspect of the practice.

Owners of a business have much more impetus to be unconditionally committed, because they reap more of the benefits or failures than the employees do. For this reason, it is rare to find this level of commitment in an employee. When you have a good leader, clear-cut goals and the correct employees, the ensuing is a beautiful machine. Doctors that have exceptional and profitable practices probably are good leaders and have exceptional employees with a well-defined common goal.

The above examples do not mean that one person should not have responsibility. The difference is in the person. While the superstar wanted other staff kept in the dark, the team player would have communicated the important responsibilities to the other staff so the office would function in his or her absence. Look for, hire and reward team players, they will make your life and practice less stressful.

An unconditionally committed employee will perform within reason to accomplish the task at hand. An applicant that won’t work overtime or on Saturdays or follow your rules of the game is only conditionally committed, and does not meet the criteria.

3. Givers vs. Takers Someone is either a giver or a taker. A giver is a loving compassionate person who truly enjoys giving of themselves. Givers understand the “win/win” concept and fully realize that the more they give, the more they will receive in return.

A taker operates in the win/lose environment in that in order for them to win, someone else must look bad or lose. Any person that speaks negatively about anything in order to enhance their own identity is a taker. A giver would complement the other person on their efforts then focus on those of their own. Although it is impossible to screen for this attribute in an interview, this behavior must be identified and these people removed from your staff. One bad apple can spoil the whole bunch! Takers are the type of employees that gossip, and gossip can cripple a practice. If, as an employer, you ever come across the “what’s in it for me?” attitude, you must take action. If an employee must have someone lose for them to win, guess who will be losing? YOU, the other staff, and the patients.

situations so all the attention swirls around them.

It is not about winning the game, it is about how many points they scored. The superstar feels that for their previous experience or superior intellect that they can “do better”. They feel a superiority and are often over protective of the doctor and the practice. Their attitude is that they must “save” the practice from the incompetent hands of the other employees. Superstars place themselves in situations that “no one else can do”. For instance, they are the only ones that can back up the computer, or the only ones that do the payroll, etc. They thrive on being needed for important functions. They frequently do this to become indispensable. Guess what, you can’t fire these employees because no one else can perform the vital functions like back up or payroll. The key to neutralizing superstar status is cross training. Give several staff responsibility for critical functions. This is good business sense and lessens the chance of fraud and embezzlement. Cross training prevents superstardom.

Some employees are intimated by change and take the “if it ain’t broke, don’t fix it” attitude.

This is poison in a motivated practice. Employees that accept and encourage change are termed offensive, while those employees that fear and resist change are termed defensive. We all like change because it counters boredom. If we all wore the same clothes every day and ate the same food at every meal, life would not be as interesting. The same holds true in the workplace.

A valid leader understands that all change may not be effective and must concede to their staff that a given plan was not working. It is alright to make mistakes and not to dwell on them, but rather to attempt to understand what went wrong, do all you can to not let it repeat itself and move forward and enhance the service to your patients. Successful practices have offensive players.

Although cosmetic surgery is not physically challenging, many doctors go home at night exhausted and stressed. They are not exhausted from doing surgery; they are exhausted from making constant attempts to steer a team to success while keeping peace.

Superstars embezzle from the practice. They don’t steal money, they steal energy. They are like sponges and they steal the energy and excitement from the other staff or even patients.

To counter this type of behavior in these “indispensable” staff, the doctor must constantly make attempts to skillfully influence situations.

This is what becomes stressful and exhausting.

Surround yourself with team players and you will be energized. Remember, we are most successful when we are doing what we love to do. My love is surgery. When I have more time to do surgery, I am happier and more energized for my family, my friends and for myself.

5. Superstars vs. Team Players

6.

The term superstar is not a positive adjective in this sense. A superstar is that type of employee that can do it all. The superstar manipulates

Knowing that we spend a significant part of our time with our staff, it makes sense to seek enthusiastic, joyous and energetic people.

Enthusiasm, Joy and Energy

BIG Medicine Magazine™

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Termination

Happiness and enthusiasm are contagious and are self-perpetuating. Friendly people with high energy levels are a welcome addition to any group of people anywhere. If you truly believe that there are no dress rehearsals in life then you should make the most out of every waking second. For a practice to approach excellence, there is no room for pessimism. Surround yourself with enthusiastic, joyous, energetic employees with the other previously mentioned attributes and your practice will prosper.

7.

Self Managing

Once you have found staff with the positive attributes, you need to make sure that they are self-managing. There are employees that know just what to do, but will not perform unless directly supervised. This is a drain because you need two people to do the job of one. There is nothing wrong with the concept of a manager, but if you must literally stand over someone to ensure progress, you have an employee that is not self-managing. Self-managing employees are a pleasure to work with and take all the effort out of management.

8.

Learners vs. Non-learners

It is always preferable to hire experienced employees, but often not possible. It is a joy to hire an employee that catches on quickly. It is stressful and regressive to have employees that need to be continually told how to do a task.

Unfortunately, some employees never seem to catch on. Our practice has a three month training period where employees are given some slack on learning their job. If they require continual instruction on learning repetitive tasks, then they probably won’t remain on staff.

Hire competent, unconditionally committed, offensive, givers that are self-managing, joyous learners and you will love your job.

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BIG Medicine Magazine™

If there is a single entity that holds back progress and perpetuates turmoil it would be the hesitancy of doctors to terminate an employee. One must make a decision to run a practice or an employee repair service. There is no doubt that terminating an employee is a decision that is wrought with emotional and legal ramifications. Firing someone or being fired can provoke so many emotions in both parties, that many doctors procrastinate or endure years of unnecessary stress because they cannot bring themselves to “pull the trigger”. It is very traumatic for an employee to be terminated as it signifies failure and humiliation. It is even worse when the employee feels that they were unfairly terminated. If an employee is terminated for being tardy and has the retort that “Mary Ann is always late”, your credibility is lost and you may open yourself to a wrongful termination suit.

The best way to avoid termination is to use correct hiring principles. This sounds so trite, but in most offices hiring is such a haphazard event that it becomes a roll of the dice. I am continually amazed by the lack of attention to basic human resource policy in medical practices. Time after time well established offices do not have written job descriptions, policy manuals, employee documentation files, and other basic information. Every office should have written policy on exactly what it takes to be an excellent employee and what it takes to be terminated. For all the above reasons, every practice needs a map and a compass. The map is the policy manual and the compass is the leader of the practice, the doctor. When the performance of an employee begins to falter, the leader must conscientiously ask themself if it is an employee or employer problem. If the employer feels that the employee is not catching on or is unsalvageable, then it is better to approach the inevitable as soon as possible. It is also important to document employee shortcomings and proof of counseling the employee. This is critical in terms of defending a wrongful discharge suit or an unemployment claim. Check with your local and state Labor Board for correct protocol.

If the proper pre-termination steps have been carried out, the actual task of termination need not be complicated. The single most important point is to have the entire script well thought out and clear in your mind. This is not

the time to ad lib or fumble around, absolute clarity is essential. It is also important to realize that if you are unhappy with the performance of a staff member, they are probably aware of this and they are also probably unhappy and sometimes the termination of employment is actually a relief to both parties. We always terminate an employment relationship on a Friday afternoon, unless a significant infraction such as theft or substance abuse has transpired. It is important to have a private environment away from other employees and it is mandatory to have an employee, preferably of the opposite sex, present to document and witness. I simply tell the employee that the employment relationship is not working. I also tell the employee that I feel that they are a fine person, but that they are just not a good fit for the practice. I tell the employee that I have a certain vision and direction for the practice and that the employee is not moving towards the goals of the practice, and again it is not a good fit. I do not delve into specifics as it opens the door for argumentation or comparison to other employees. It is imperative not to insult the employee and important to leave them with self-esteem. If the situation is applicable, then we offer the employee the ability to resign with severance benefits or be terminated with no benefits. It is acceptable to have a manager do the actual termination, as long as the proper channels are followed. In fact it may be wise for the doctor to distance his or her self from these proceedings and stick to doctoring.

It is an absolute necessity to obtain any keys, credit cards or any other practice possessions immediately. There are many cases of documented sabotage involving the violation of this procedure.

An even greater temptation for sabotage is to terminate an employee with two weeks’ notice. This a perfect invitation for this person to be unproductive or diabolic within your office. A prudent employer will already have a replacement lined up to step right in the position.

To have an all-star team, you have to be ready to play an all-star game.

Dr. Joseph Niamtu is a cosmetic surgeon who practices in Midlothian, VA

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Taking on the World Developing A “World Class” Medical Practice Angela O’Mara

As President of The Professional Image, Inc. and Editor-in-Chief of this magazine, I have had the privilege to work with many medical industry leaders who have over time developed a World Class Practice.

Being World Class does not mean being known the world over. It means bringing a quality and value to your practice, your patients and your life that is unsurpassed anywhere else. The popular saying “Rome Was Not Built In A Day” applies here as developing a World Class Practice does not happen overnight either. It requires many things, including constant care and nurturing and, the least of which, recognizing opportunity.

For over twenty-five years, I have worked with hundreds of physicians to help them build a “world class” medical practice and business through public relations, marketing and consulting. My clients and I have survived at least three recessions, including the most recent one, and understand that each one brings a new set of challenges, as well as opportunity. Focusing on the opportunity will lead to excellence in all areas of your life and business practice.

In today’s fast-paced, high-stakes, competitive medical environment, looking at your practice from a “business” point of view will provide enormous benefit. At TPI, we have developed a 7 Step System that will help you gain clarity and equip you with skills to not only navigate this new economy, but proven skills that will help you build a “world class” practice that matches your level of surgical expertise.

By exploring various alternatives to your current methods, you will feel: • An increase in motivation • Have a higher degree of accountability within the practice • Find a greater focus with pinpoint clarity

• Surround yourself with a strong team that understands what you want to achieve • Develop a vision of your future • Assess your current reality

• Identify and enhance personal strengths

• Initiate new public relations and marketing programs

• Identify and eliminate/minimize practice weaknesses

• Learn how to maintain your success

• Have increased effectiveness and confidence

• Ultimately feel engagement, fulfillment and reward in your professional life

• See a higher level of organization and structure

• Develop a solid strategy

• Realize the ability for greater earning potential • Find time for personal pursuits, family and friends

“You can start by finding a moment of uninterrupted time so that you can sit down with a pen and paper and begin a brief analysis of yourself, your practice and where you want to take it. The sky’s the limit! And the time is right to let the world know just who you are.” Angela O’Mara.

Those that have traveled the London Underground will recognize this phrase. It is used to let travelers know that between the station platform and the train, there is a small but dangerous gap that must be crossed in order to step on the train and thereby reach your destination. The same is true of your practice. Between “what you have” and “what you want” is a gap. Between where you are now and that “world class” status is a gap. The first step towards practice success is to realize what this gap is and how to safely cross it. For most of us there is generally something lacking. This lack might be money, time, energy, quality staff, location, adequate space, technology, business plan, team spirit, to name a few. Start by doing a practice-assessment to find your gap (go to www. bigmedicinemagazine.com/bigstrategy for your FREE questionnaire.) questionnaire.

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• To make a commitment to yourself and to your personal success

• Develop a clearer sense of direction

Mind The Gap

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To do this, you need:

When doing an assessment consider the following areas: • Personal Effectiveness • Practice Leadership • Staff Leadership • Marketing Needs List • Sales Programs • Team Ability • Time Spent on Superior Skill • How Supportive Is Your Environment • Organization • Finances • Personal Health and Well Being • Inter Office Communication

Envision Your Future While none of us need a crystal ball to tell us that things have changed, it will take some insight on your part to develop your own personal vision and determine how you are going to adapt to the changes, and develop the “world class” practice you deserve. As they say, what you see is what you get.

Take A Reality Check To begin, many of us are in denial about the current situation, are operating out of fear, or are too overwhelmed with daily minutiae to want to find the time to face the facts.

However, in order to be successful and survive a failing (or failed) economy, to do your best and build a more secure financial future, you are going to have to take out that pen and write yourself a prescription for success. Generally, once you do this, things are not always as bad as they seem and you begin to see the opportunities that are placed in front of you every day. By doing the personal practice assessment first, it will help you have a clearer view of your current reality. When I have gone through this phase with a physician, it always amazes me to see how many open ended and incomplete projects they have that are holding them back. Once you do the analysis it helps you decide which of these projects are worthwhile (if any) and let go of the ones that are going nowhere. This gives you fresh ground to begin to build toward your success.

Prescription For Success Developing a strategy for your practice and implementing it is vital to your success.

Your strategy should include long and short term goals, and daily action items. As well as including goals, your strategy should also include financial needs and financial growth opportunities, staffing needs, role designations, ideal marketing budgets and outlets and, of course, time off for you so you can regenerate.

It’s easy to build surgery and consultation time into the weekly schedule, but not as easy to include time for business building, planning, implementation meetings, creativity, sales goals and other assessments (including a round of golf or other leisure activity) that are critical to the health and future success of the practice, and you.

Jumping In Until you implement a strategy, you don’t actually know if it’s going to work. Of course, you can follow the example of others, or copy things they have done, but don’t forget that this is YOUR vision that you are creating and there is not a one-size-fits-all rule here. The world class surgical skills you learned in school, residency, fellowship programs and your own practice did not happen overnight. And, guess what, your

skills will only continue to get better and mature with time. In order to achieve “world class” recognition you must be willing to devote the same time to it.

Making fundamental choices to change your life can seem risky. Making grandiose ideas come to life seems risky too, but the payoff will be tremendously lucrative and will free you up to really enjoy life the way you “In my 25 years of working in the medical industry almost all want to. The riskiest thing you doctors tell me they are happiest when they are doing surgery.” can do is nothing. Inertia is NOT Angela O’Mara going to make it through in any economy – good or bad. Get Keeping Your Edge proactive about your practice success and you Just when James Bond takes that final leap will find that it will ignite excitement, not just in looking battered, tired and dusty, we think “this you, but in your staff too. must be it for him” but it never is because he never gives up. And he always comes out Public Relations and Marketing looking suave and debonair and ready for the There are no mysteries to solid, strategic PR next adventure. Like James, you also need and Marketing but in an economy like this you to learn how to keep the “edge.” To keep your have to stop wasting time and money on hiring name in lights, to keep your practice thriving, the wrong people or thinking that you can do to keep living your life the way you want, you everything for yourself. I tell my clients “You keep must be vigilant about your success. While this doing what you do best – surgery, and I will will not take as much of your time as your initial keep doing what I do best, PR and Marketing.” “gear up to success” has, it is still an area that It works too because all of my clients are should be constantly monitored in weekly staff holding steady with practice revenues and meetings where you can keep a close eye are continuing to see themselves on TV news on sales increases, budgets and spending, shows and are regularly interviewed by the ROI (return on investment), staff and attitudes, media. They are all considered “world class” leadership and the other many details that lead world authorities in their respective fields. With PR to total success and personal fulfillment. and Marketing you also have to do a separate strategy that is different from your practice building strategy. You also must surround yourself with people that can implement a highly creative campaign that gets attention.

Public relations is still the most credible and cost-effective way to promote a practice.

Appearances on TV and articles written about you in newspapers and magazines offer a third party endorsement that advertising and internet promotion cannot. This is a good time to evaluate everything from logo and stationery, to brochures and website, advertising, social media and branding, events and PR effectiveness.

Being “world class” can mean many things. In the current environment I would suggest that you attempt to be “world class” in all aspects of your practice and your personal life. Not only will you feel great about your creation, but your staff and patients will appreciate it too. And the payback to you will be incredible. Enjoy!

You have worked hard to get where you are. Isn’t it time you started enjoying it?

Note: To order your copy of “Lights!

Camera! Action! The Plastic & Cosmetic Surgeon’s Guide to Obtaining Priceless TV, Magazine and Other Media Exposure” it is available at www.amazon.com and www.theprofessionalimage.com

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We Asked The Doctors!

They TOLD US! Dr. Bacot

Dr. Kridel

Dr. Fleming

Dr. Jao

Dr. Lee

Dr. Bunkis

Dr. Kapoor

Dr. Daniels

Dr. Mayer

Dr. Pearlman

Dr. Noodleman Dr. Moelleken

Dr. Chong

Dr. Will

Dr. Frankel

Dr. Sadati

Dr. Niamtu

What NEW item, action or service do you plan to add to your practice this year?

“Effective non-invasive body-contouring.”

Marcel Daniels, M.D., F.A.C.S., Long Beach, CA “Refinement of the 360 Facelift.”

Brent Moelleken, M.D., F.A.C.S., Beverly Hills, CA “I plan to keep patients more involved in skin care and minimally invasive procedures.”

Joe Niamtu, III, D.M.D., Midlothian, VA “Fractora Radiofrequency skin treatment.”

Rick Noodleman, M.D, Campbell, CA “Fat grafting using stem cell extraction techniques.”

Lavinia Chong, M.D., F.A.C.S., Newport Beach, CA “Adding an associate will allow me more time to write a long in process textbook on Rhinoplasty and will re-energize both the staff and me.”

Russ Kridel, M.D., F.A.C.S., Houston, TX “We will shortly be implementing the use of Cellulaze, the only treatment that actually is effective in removing cellulite.”

Harrison Lee, M.D., D.M.D., F.A.C.S., Beverly Hills, CA “Will add several staff and focus on efficiencies and service-oriented processes.”

J. David Holcomb, M.D. Sarasota, FL “We are going to increase our social media presence since this is how much of the rest of the world keeps abreast of new insights and technology.”

Steven Pearlman, M.D., F.A.C.S., New York, NY

“Combining the most advanced modern technologies with a holistic approach, so we can formulate an individualized, comprehensive plan for patient wellness.”

Kedy Jao, D.O., F.A.A.F.P., La Mirada, CA “Expand our non-invasive treatment modalities to decrease patient recovery times.”

Michael Will, DDS, M.D., F.A.C.S., Ijamsville, MD “A CO2 laser for facial rejuvenation.”

Vishal Kapoor, M.D., Beverly Hills, CA “Bringing a new associate into the practice. Also looking into purchasing a new laser.”

Juris Bunkis, M.D., F.A.C.S., Rancho Santa Margarita, CA “We are adding a specialist in breast augmentation and reconstruction as well as massive weight loss issues.”

Toby Mayer, M.D., F.A.C.S., Beverly Hills, CA “Having specialized in facial plastic and cosmetic surgery for over 35 years, we have added a plastic surgeon to do the body work in our clinic.”

Richard Fleming, M.D., F.A.C.S., Beverly Hills, CA “Further streamlining our services and adding a concierge surgical suite to our facility.”

Brian Bacot, M.D., St. Thomas, VI “Expanding my practice to include a Medical Spa.” Kevin Sadati, M.D., Newport Beach, CA

“An App for my practice and upgraded web sites.”

Andrew Frankel, M.D., F.A.C.S., Beverly Hills, CA

If you would like to participate in our “We Asked The Doctors They Told Us” section, write to us at www.bigmedicinemagazine.com.

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So You Want To Be A Doctor?

HERE’S WHAT YOU REALLY NEED TO KNOW! Not that we doubt you are questioning your choice of career, however, at BIG Medicine Magazine™ we do get lots of questions from doctors asking how they can adjust to this economy we call medicine so we asked Dr. Gregory Buford, a plastic surgeon and author of Beauty and the Business, for suggestions that might help you put your best surgical foot forward.

At the ripe old age of 7, I told my parents to stop calling me Greg and begin referring to me as Dr. Bill. Strange you might think, especially for a boy that did not come from a family of doctors and who did not know anyone named Bill. That was then, this is now and after years of training and perseverance I can now call myself “doctor”. This title has brought with it frequent requests to encourage others about a career in medicine. But, as happy as I am in my decision, I need to make a small confession. I do not recommend this path to just anyone. So why would I not recommend a medical career? The answer is complex and the journey much different and more challenging. To better understand how medicine has changed, we need to consider three factors: Technology, Relationships, and Entrepreneurship.

Technology. As much as we love to embrace technological advancements, they bring added responsibility to maintain a learning curve that is increasing at a rapid pace. Many of these new procedures, devices, and products were never dreamed of when we were in medical school and suddenly they are available to us. The challenge lies in determining not only how best to use them, but ultimately understanding their real efficacy. And while a new device may be beneficial, there may simply not be room in the budget to incorporate it.

Relationships. More to the point, the patient-physician relationship. The Internet has forever changed medicine by providing immediate information on every aspect of health care that empowers patients with information they can use to better their health, making the patient more pro-active. With that comes responsibility for both parties to interact in a new way. Physicians must listen to their patients and patients must exercise compliance with their provider’s advice.

Entrepreneurship. Physicians are taught procedures and how to deal with disease. We were never taught how to run a business. In fact, many of us were told (point blank) in our training that “medicine is not a business”. It should come as no surprise that many physicians face tremendous frustration coming out of medical school leveraged with debt, trying to start a practice, but not knowing where to turn for solid advice. Add to this a political atmosphere where the easy solution for cutting health care expenditures is simply reducing physician reimbursement and you are looking at an incredibly hostile and scary environment.

So why do I keep practicing medicine? Simple. Medicine has changed, but many of the aspects that challenge us can become the same tools with which we can actually take health care to a new exciting level.

CONSIDER THIS! Technology. Is the lifeblood that allows us to achieve increasingly more natural and more durable patient results. Many of the procedures and devices we use were not available during our formal training. Tremendous responsibility rests on our shoulders to not only educate ourselves to this brave new world but also to learn how to effectively harness it through the appropriate training channels.

Relationships.

Communication is another component of medicine that has changed dramatically but is actually changing for the good. We never expected to reach potential patients through blog postings but today this is a reality. As a frequent writer, even though I am working harder and longer to distribute information online, I am also creating a client base that is far more engaged and proactive in the health care delivery process than ever before.

Entrepreneurship. This may be the biggest challenge. I recently had the honor of joining the world’s largest group of innovators, the Entrepreneur’s Organization (EO). I joined because I was frustrated at what I felt was my lack of business acumen. I quickly became aware that running a business is not the most important key to growing a medical practice—entrepreneurship is. The days of simply hanging a shingle and waiting for patients to come are over. Through my interactions with fellow EO members, I have changed how I view my practice. I now view it as a startup. My product is good results but my ultimate goal is to bundle these results in a positive and branded patient experience.

“My gut feeling is that the new age of medicine lies in this direction and that those of us who heed the challenges and embrace them as stepping stones to a higher level will take health care, and their practice, to a new level.” Dr Gregory Buford.

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Where There’s Money There’s MISCHIEF!

For one doctor it started with medical vendors thanking him for paying them twice in one month.

For another doctor it started with a few missing checks.

For both of them, they were seeing a shrinking profit margin, higher overhead, unnecessary purchases and undocumented bonuses. Busy with patients, staff requirements and insurance outlay, the doctors rarely took time to review their accounts, trusting that their finances were in the hands of a loyal and dedicated employee. Employee embezzlement has reached epic proportions, costing U.S. businesses some $652 billion annually, according to the Association of Certified Fraud Examiners. www.acfe.com.

Medical groups are particularly vulnerable, especially those in private practice.

Many physicians grant exclusive bookkeeping authority to one person. Some even give that person power of attorney over the practice. Both of these are fatal mistakes. According to experts there are classic mistakes doctors make.

• They don’t review their credit card statements • They don’t always sign their own checks • They do not keep track of insurance billing and reimbursement • They don’t review in-house bookkeeping records or patient payment schedules • They don’t monitor bank deposits or know when a reimbursement check was received, or when cash was used as payment • They don’t compare regularly (if ever) the in-house bookkeeping record against the bank statements Becoming familiar with employee theft and embezzlement schemes can help you formulate protective strategies. Many thefts occur at the front desk, where employees simply pocket the cash paid for copays and other fees. The office checkbook is another popular method for misappropriating funds. The person committing fraud simply writes a practice check for personal use and then records it in the check register as a practice expense.

Dishonest employees in smaller practices (who handle most if not all of the accounting responsibilities) have been known to open a second account in the practice’s name, deposit money into it using a signature stamp, and treat it as their own. The physician never knows the account exists. Patient refunds are another favorite among petty thieves. Larger practices process hundreds of refunds a month, so it’s easy to process five or six fictitious ones using a patient’s name (or an invented one). The employee then takes the falsified refund checks and deposits them into their own account using an automated teller machine (ATM) and they almost always get away with it.

There are many ways to catch a thief, and many more ways for a thief to ruin you. Be on your guard!

Can Spelling Mistakes Cause A Loss In Revenue?

According to a recent article published by the BBC (British Broadcasting Company), poor spelling can cost millions of dollars in lost revenue for internet businesses. Entrepreneur Charles Duncombe says an analysis of website figures shows a single spelling mistake can cut online sales in half. Sales figures suggest misspellings put off consumers who could have concerns about a website’s credibility. Poor spelling is a serious problem for the online economy, he says. Most medical practices now have an on-line presence, be it a website, blog or social media page. However, when a patient contacts your office asking questions via email, the questions to ask yourself is “who is answering these emails,” and “can they spell correctly?” Remember, 99% of the time, on-line communication is done using the written word. Even college graduates are using text speak in their communication. As time consuming as it seems, you might want to review all document templates used by staff members, and monitor outgoing emails to make sure that spelling mistakes are not costing you money.

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Who’s Looking After

Your Parent’s Money?

Like everyone else, physicians have aging parents with personal and financial needs. But who will take the reins when your parents are no longer able to do so? What if the stress of managing your parents and their finances becomes a burden to you, or worse, causes fall outs within the family unit. BIG Medicine Magazine™ talked to Herb Cohen, of Fiduciary Plus. Herb has worked with many physicians in this regard.

My father-in-law was well into his 90’s when he was hospitalized and began a quick descent, health wise. His situation was further complicated by living some 3,000 miles from my wife and me, the only people willing and able to help with medical decision-making, residence choices, and management of financial affairs. This was a difficult learning experience and one that made me think about who would be there to help if family is not available, or family dynamics rule out one or more relatives. The answer turned out to be licensed private professional fiduciaries who, by court appointment, serve as guardians, conservators and personal representatives of estates. They also serve by agreement as trustees, representative payees, or as agents under powers of attorney. Additional information is available on the Professional Fiduciary Association of California website [www.pfac-pro.org]. Outside of California go to www.guardianship.org.

After this situation with my family I decided to use my prior legal and financial experience to become a private professional fiduciary. I serve my clients in one or more of the above capacities. A typical client is between 75-100 years of age with no children; or the children are otherwise engaged; or there is conflict, and possibly litigation, among family members; or the parent passes away without an estate plan. A professional fiduciary can help ease the pain among family members by acting as an unbiased liaison and expert decision maker during this difficult time.

A memorable case is where an MD client with a family and busy practice came to know that his adult sibling was stealing from their elderly mother’s trust and brought suit against the sibling. The forensic accounting that I produced documented the theft with the information used to remove the sibling as trustee and bring charges against him. None of us want to think that this type of thing happens in families but, unfortunately, it does.

Most physicians, or parents of physicians, probably have planned their future by preparing an estate plan in consultation with legal and financial advisors. They may even have periodically amended the Plan to reflect changing circumstances. But the weak link often is implementation at a stage in life when one is least able to take care of financial choices. Often times, when this situation is finally realized by other family members it can be a mess to sort out.

What to do? The chart below will identify the primary alternatives of who or what is able to assist you, and the up and down side to each.

Family Member or Good Friend to serve as power of attorney, successor trustee, or executor

UP SIDE: high level of trust; little or no cost

Financial Institution – Trust Banks or non-profit entity

UP SIDE: professionals; no concern for succession; large staffs

DOWN SIDE: nominee not capable of dealing with complexities nor available when the need arises; distrust within family

DOWN SIDE: expensive; bureaucratic; inflexible. Focus is on managing finances not personal or health matters Licensed Private Professional Fiduciary

UP SIDE: licensed by a State Agency with public disclosure; bondable; moderate expense; personal service DOWN SIDE: potential succession issues; geographical reach is limited

As physicians, you make medical determinations about the competency of your patients and address insurance matters, HIPPA rules, and the concerns of your patients’ families. A licensed fiduciary can do that too. You pay bills, including taxes, and spend time with investment advisors. As do I in my capacity as power of attorney, successor trustee, conservator and/or estate administrator. Just as physicians have a professional but intimate relationship with their patients, so do licensed private professional fiduciaries.

The relationship starts with one or more meetings and the fiduciary’s review of the documents which govern their responsibility and liability to the client and his/her family. The critical element is trust and confidence, as it is in a medical practice. The fiduciary has the legal and ethical responsibility to carry out his clients’ wishes, and the client has to have trust and confidence in the fiduciary to do so.

Keeping a family happy is important. Keeping an aged parent safe, secure and living within the means they planned for is imperative.

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All jokes aside, it can be tough to be a doctor and especially one who uses the media to further their brand. To be a doctor on TV, you must also back it up with academics, education and stellar patient results. To be a doctor on TV you must also remember to never take it all too seriously. Life is too short not to have fun.

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Marcel Daniels, M.D. Plastic Surgeon Long Beach, CA

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Are You A

REAL DOCTOR?

Those are the famous words of soap opera actor Peter Bergman when he did a 1986 commercial for Vick’s cough syrup.

TV has made a lot of other doctors famous too. Real and imagined. Dr. Doug Ross has a Wikipedia page detailing his entire medical career. So does Dr. Gregory House. Neither of these men are real doctors. Dr. Ross was a character played by actor George Clooney on the TV show ER and Dr. Gregory House, better known as House, is played by British actor Hugh Laurie. Both ER and House have won Emmy’s and Golden Globes. Another highly popular medical TV show, Grey’s Anatomy, became the highest-rated drama in the key demographic – the 18-49 year old age group, and was among the overall top-ten rated TV shows in the United States. So what does this tell us? That America LOVES its doctors!

Now many of you may have the opinion that there are real doctors on TV news shows and documentaries that are less qualified than you, or may have less experience than you and you are wondering “How the HECK did they get on TV?” For the moment though, let’s take a walk down medical memory lane and look at the “Who’s Who” in Medical TV history.

Medical shows, comedic or dramatic, play a BIG part in the lives of the American consumer and some of these doctors have become the most loved and recognized TV characters of all time. Perhaps there are a few “pearls” to be gleaned from this line up.

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Benjamin Franklin “Hawkeye” Pierce (Alan Alda, “M*A*S*H”)

Cliff Huxtable (Bill Cosby, “The Cosby Show”)

Adapted from Robert Altman’s 1970 film MASH, the long-running TV series was a gentler version of the original comedy about doctors in the Korean War. Alan Alda’s Hawkeye Pierce was the show’s anchor, using humor to deflect the tragedy around him.

Dr. Cliff Huxtable was the amiable and bemused father figure who was always ready to deliver advice, when he wasn’t delivering babies. Bill Cosby’s character helped the show run for eight seasons from 1984-1992, and it was one of the biggest shows of the 1980s.

Marcus Welby (Robert Young, “Marcus Welby, M.D.”)

Doogie Howser (Neil Patrick Harris, “Doogie Howser, M.D.”)

Robert Young played the friendly family doctor Marcus Welby who first appeared in a movie-of-the-week in 1969 and returned later that year to star in a series that ran through 1976. Although the theme may not fit current types, his character remains one of the most indelible TV doctors of the era.

Doogie Howser breezed through school to become a doctor at 16 (only on TV), which meant he had to tackle the trials of being a teenager while also dealing with the adult pressures of the medical world. The show made Neil Patrick Harris a household name and he remains in the spotlight today.

James Kildare (Richard Chamberlain, “Dr. Kildare”)

Doug Ross (George Clooney, “ER”)

Dr. James Kildare was a fictional doctor on radio, TV and in comic books dating from the 1930s, into the 1960’s and with a short lived TV series in the 1970s. The most memorable version of Dr. Kildare was played by Richard Chamberlain. The show quickly achieved success, encompassing 190 episodes and sparking a new generation of medical shows.

“ER” ran for 15 seasons and moved a large number of actors through its cast but initial star, George Clooney, was the show’s most defining presence then, and now. Clooney played Dr. Doug Ross a caring pediatrician willing to break the rules to help people; he left the show during its fifth season. America will never forget that George Clooney’s big break was in the “ER”.

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NO!

I Just Play One On TV

Miranda Bailey (Chandra Wilson, “Grey’s Anatomy”)

Sean McNamara & ChristianTroy (Dylan Walsh & Sean McMahon “Nip/Tuck”)

“Grey’s Anatomy” has been popular since its 2005 debut, and a big part of that is the supporting work of Chandra Wilson as Dr. Miranda Bailey, whose tough persona helps shape the younger doctors. A first for female doctors, Miranda shows us how difficult the world of medicine can be.

They say truth is stranger than fiction. This show made plastic surgery even more popular due to its bizarre plots and even more bizarre procedures. Not to mention the fast cars, handsome doctors and gorgeous half naked models. The show earned 45 award nominations, winning a Golden Globe and an Emmy Award. According to the Internet, series creator Ryan Murphy says that the medical cases on the show are “100 percent based on fact”.

Julius Hibbert (Harry Shearer, “The Simpsons”) On a lighter note, we can’t forget about the cartoon doctors. Always chuckling and seemingly indifferent to the ups and downs of life in Springfield, Dr. Hibbert, a spoof of Cosby’s Huxtable, is one of the most enduring and hilarious characters on “The Simpsons.”

Leonard “Bones” McCoy (DeForrest Kelley, “Star Trek”) Neither can we forget about space doctors.

“He’s dead, Jim.” Leonard McCoy was a surgical staple of the original “Star Trek” TV series. Known for his dry humor and comic pessimism. Dr. McCoy was not quite the doctor to the stars, more like the doctor in the stars, pun intended. He even put in an appearance in the pilot episode of “Star Trek: The Next Generation.”

Gregory House (Hugh Laurie, “House”) Hugh Laurie was a well-known comedic actor in England before his performance as the ailing and grumpy Dr. House brought him widespread recognition in the U.S.A. House is a tough man, but not without compassion for his fellow doctors and patients, although sometimes it’s hard to see. The series has remained popular even after six years on the air. At one point House was among the top-ten rated shows in the USA, has been distributed to 66 countries, and has received five Emmy’s, two Golden Globe Awards, a Peabody Award and nine People’s Choice Awards.

So next time somebody asks if you want to be on TV, you might want to say YES! BIG Medicine Magazine™

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Industry Transformer

Smile and The World Smiles With You Face Lift Dentistry® Treatment Preventing Premature Aging with Hi Tech Dentistry Dr. Sam Muslin We all know that a great smile can light up a room. But did you know that there is a new level of Hi Tech Dentistry that is providing better aesthetics for the entire face and profile while reversing the signs of aging? With a specialty focus of transforming lives by not just creating a phenomenal smile, but also improving facial shapes and proportions even when you are not smiling, Santa Monica based Cosmetic Dentist Dr. Sam Muslin has developed a new paradigm in health and cosmetics. We all know that several cosmetic dentists promise us that perfect Hollywood Smile, but now the bar has been raised beyond just typical “smile dentistry”. We are moving into a whole new realm of anti-aging Face Lift Dentistry® that strives to improve facial shape and proportions that not only prevents premature aging, but also reverses the aging process.

The Face Lift Dentistry® procedure is the first dental treatment to idealize profile proportions, improve jaw position, and provide better support for the soft tissue of the face without surgery. Dr. Sam Muslin created the Face Lift Dentistry® procedure, a system of assessing and treating facial cosmetic issues that goes far beyond “Just the Smile”.

Now we all know that to achieve the full effects of a real facelift surgery requires a skilled plastic surgeon, however, Dr. Muslin is finding that dental aesthetics can go hand-in-hand with plastic surgery and, as pioneer of the Face Lift Dentistry® treatment, he is paving the way for the future of true facial harmony. The Face Lift Dentistry® treatment actually permanently lengthens and re-shapes the face while idealizing the jaw position. Cosmetic Dentistry alone cannot offer this same result. Dr. Muslin is now teaming up with other physicians that specialize in plastic surgery of the face to bring patients a new option in age reversal.

The Face Lift Dentistry® procedure makes the most of facial characteristics to naturally improve the smile, profile proportions, facial shape, jawline, and overall health of a patient.

Thin lips can appear fuller without artificial fillers and implants because the newly improved teeth and jaw position better support them.

The face is permanently lengthened to a more youthful shape to smooth out wrinkles and

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minimize fine lines with his exclusive Face Lift Dentistry® bite correction method. The jawline is stronger and in better proportion to the rest of the face, so that a patient’s appearance is improved from every angle even when they are not smiling. This procedure improves the shape of the patients face in a way that is not possible with any other cosmetic treatment. Additionally Face Lift Dentistry® treatment has a huge health benefit by idealizing the jaw position.

Dr. Muslin, who is a Master of the Academy of General Dentistry says, “the most important aspect of the non-surgical Face Lift Dentistry® procedure is the geometrical, functional and three-dimensional analysis that I develop for each patient.” According to Dr. Muslin, every single person needs something completely different to improve his or her face and profile.

He uses a live motion camera so patients can observe themselves to see what he sees from all angles. Plus he takes over 50 different photos from various angles and expressions to develop the absolute best facial support and jaw position within biological limits.

The Best Cosmetic Dentist and More The Face Lift Dentistry® procedure requires highly specialized equipment, many years of experience, and the ability to think beyond standard cosmetic dentistry. In order to achieve the very best results for the patient, the dentist must have the vision of an artist along with the

technical capability to move accurately and quickly. Dr. Muslin has spent most of his postgraduate years perfecting his techniques and now caters to a select group of patients who fly from all corners of the world seeking the most advanced cosmetic dentistry so that they look younger and live healthier.

Dr. Muslin says that each patient he sees presents a different set of health and aesthetic problems, and every patient wants a unique look. No Chiclet teeth here! With over 30 years of Hi Tech dentistry experience Dr. Muslin offers his patients the latest technology and superior artistic skills for results that are natural looking and as functionally comfortable as possible.

Whether the goals are purely cosmetic or there are significant TMJ health issues to resolve, in the end each person will have anti-aging results that will last.

Take A Bite Out Of This What most people do not realize is that their teeth and bite position directly impact the shape of their face and the support for their soft tissue. As we age our teeth become shorter every year from normal chewing and grinding. This tooth shortening leads to a loss of vertical dimension in our faces. Oval shaped faces become round and fat. Jawlines recede into weak chins. The distance between the tip of the nose and the bottom of the chin is literally getting smaller every year. Soft tissue

Industry Transformer

“Whether the goals are purely cosmetic or there are significant TMJ health issues to resolve, in the end each person will have anti-aging results that will last.” Dr. Sam Muslin.

sags and wrinkles, while lips become thin and compressed. Worst of all, while your chin moves north, your soft tissue succumbs to the force of gravity and moves south making you look old. Dr. Muslin will tell you that, people look old because they never had the best bite for their faces.

The bad news is that the shape of a face and its bite position are formed between the ages of 6 and 13 without any precision. Very few of us had a perfect bite to begin with but over time even the slightest bite issue is exacerbated and the results show up on the face. Lips that were once full can look squished and thin. Soft tissue that once tracked the jawline begins to sag and wrinkle. All of these effects are exacerbated by a bite and jaw position that is not ideal. By optimizing the teeth for an ideal bite and jaw position, the aging face can appear naturally years younger. Patients who look older than their actual age, or even angry because of short and worn down teeth, can reverse these signs of aging while improving their health.

Other patients of Dr. Muslin suffer significant bite issues like underbites, overbites, and cross bites. All of these conditions have significant health consequences and the cosmetics are not any better. Overbite conditions force the lower jaw back causing a weak chin, while underbite conditions push an oversized

lower jaw forward. Some people suffer with extensive TMJ pain, muscle tightness, and tension headaches that are in a large part attributed to their bite and jaw position. Too often this is not diagnosed before the pain is extensive and some damage is irreversible.

Regardless of the bite condition the Face Lift Dentistry® procedure offers an effective over bite correction and under bite correction that improves the jaw position while dramatically improving the smile, facial shape, and profile.

Aesthetics Are Everything Sometimes the aesthetic goals of the patient require a dual approach. The bite and jaw position is idealized with the Face Lift Dentistry® procedure while the plastic surgeon improves the tissue appearance. Several of Dr. Muslin’s patients have undergone facelifts or implants both before and after Face Lift Dentistry® and the results are unprecedented. It is remarkable how a chin looks far better after the jaw is ideally positioned. Likewise a facelift appears even more impactful when the face is restored to a more youthful shape. There are certain changes that only a plastic surgeon can make and certain changes that only the Face Lift Dentistry® procedure can make so working together can be key.

One of the best parts about the Face Lift Dentistry® procedure is that it is non-invasive.

This means that grinding on healthy natural

teeth is not necessary. Any existing old fillings, crowns and decay are removed and natural healthy teeth are cleaned. Specialized porcelain veneers and porcelain Venlays™ are artistically crafted to function as an organized system to create the bite and jaw position needed. This system is three dimensionally designed by Dr. Muslin to support soft tissue, enhance the profile and optimize the facial shape for each person individually. Once the porcelain is bonded into place the results are immediate and there is no healing time.

Biological Compatible Materials With biologically compatible dental materials, and all infection removed from the mouth, the health of the patient is dramatically improved. There is no drilling on their healthy natural teeth so all of the benefits are without any compromises. For the first time in their lives, people have a bite and jaw position that is not only ideal from a health and function standpoint, but one that also looks phenomenal. The facial reshaping and jaw re-positioning results of the Face Lift Dentistry® procedure are unprecedented in the field of cosmetic dentistry. Perhaps more than anything it is the ability to improve your health while looking years younger naturally that is life changing for so many.

Dr. Sam Muslin is the Face Lift Dentist® in Santa Monica, CA. BIG Medicine Magazine™

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Industry Transformer

Melasma

Changes in Hormonal Levels For Dr. John Shieh of RejuvaYou Medical Spa in South Pasadena, CA working with celebrities means that he works with those IN FRONT of the camera, and those BEHIND the camera, as in the case of Kerri Kasem a well-known radio and TV host. For Kerri even though she is known as the voice of radio, she still makes many public appearances and counts Dr. Shieh’s non-invasive approach to health and beauty among her celebrity secret weapons. Dr. Shieh has been a trail blazer in his approach to noninvasive anti-aging treatment, but where he really feels he is making a big difference is for those patients who suffer with melasma.

Dr. Shieh was excited when the FDA approved the LUTRONIC Dualpulsed Q-switched Nd: YAG SPECTRA™ laser for melasma and other skin conditions (including tattoo removal) as he was able to finally offer his patients a solution that worked and was safe. He quickly adopted this new technology and it is paying dividends in happy patients. “We have used bleaching creams and other topical skin treatments to treat melasma but it has always been a struggle to obtain a good result. The Lutronic SPECTRA™ is ground breaking technology and has proven to be a miracle worker in my practice,” said Dr. Shieh.

Melasma is more prevalent in women than it is in men and also affects people with darker skin, such as those of Latin/Hispanic, North African, African-American, Asian, Indian, Middle Eastern, and Mediterranean descent. People who have a blood relative who had melasma are also much more likely to be at risk. Although causes of melasma are not yet clear, the AAD (American Academy of Dermatology) says that it likely occurs when the color-making cells in the skin (melanocytes) produce too much color. People with skin of color are more prone to melasma because they have more active melanocytes than those with light skin.

Common Causes of Melasma Sun Exposure: Ultraviolet (UV) light from the sun stimulates the melanocytes.

Even a small amount of sun exposure can make melasma return after fading, which is worse in summer. It is also the main reason why it returns again and again.

A Change In Hormones: Pregnant women often get melasma, which is also called chloasma or the mask of pregnancy. Birth control pills and hormone replacement medicine also can trigger melasma.

In addition to treating melasma, Dr. Shieh says his individualized approach to skin rejuvenation in general is what keeps his celebrity patients in the public eye. “In many instances, cosmetic treatments have become “a la carte” depending upon which cosmetic counter you visit, rather than “personally individualized” as we offer at RejuvaYou,” stated Dr. Shieh.

It’s no wonder that Dr. Shieh’s practice continues to be popular among a growing clientele. Using the right technologies with a comprehensive approach is a formula for success.;

Dr. Shieh offers the “RejuvaYou 5 Star” approach to getting camera ready: 1. Discoloration: remove/reduce brown spots, red capillaries, fine lines with appropriate lasers.

2. Laxity: loss of elasticity causes sagging. Restoring elasticity via laser, light, and radio-frequency energy treatment is vital.

3. Deeper Lines and Wrinkles: are removed with deeper peeling agents and laser treatments.

4. Volume: loss of volume ages the face.

Volume is restored with fillers and/or fat transfer.

5. Prevention: Sunscreen and Botox® are used as preventatives to control future wrinkles and sun damage.

Cosmetics: Skin care products that irritate the skin may worsen melasma.

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Industry Transformer

The Robotic Hair Revolution is Here!

With a celebrity following that is unsurpassed, Dr. Craig Ziering is a true leader in hair loss solutions for men and women, and he continues to pave the future of hair restoration with the addition of Robografts! Robografts are in high demand in Hollywood -- where A-Listers request Robografts over the long-standing mircrograft. You might wonder how a robotic system could contribute to such a delicate and individual treatment such as hair restoration, but the ARTAS System designed for Follicular Unit Extraction (FUE) and as used for the first time in California at Ziering Beverly Hills, is an interactive, FDA-cleared, and physician-controlled robotic system that makes hair restoration for both men and women even more effective and provides completely natural looking results.

A Combination of Art and Science

A pioneer in the field of surgical hair restoration and this Follicular Unit Extraction (FUE) harvesting technique, Dr. Ziering combines art, science and the most advanced technology to create exceptional, natural looking results for his patients. His refined eye for aesthetics perfectly complements his advanced hair restoration surgical skills, allowing him to offer superior solutions to those who want to win the battle against hair loss and thinning hair. With more than 20 years of experience in the latest surgical techniques, Dr. Ziering has performed thousands of successful hair restoration surgeries at his clinics in Los Angeles, Newport Beach and Las Vegas. In addition to successful hair restoration surgeries, Dr. Ziering is an expert at creating permanent facial hair solutions in the areas of eyebrows, beards, sideburns, and moustaches, as well as restoring hair lost through trauma, burns or radiation.

Over 50 Million Men Are Affected By Hair Loss Recent surveys show that more than 50 million men in the United States alone are affected by male pattern baldness or androgenetic alopecia. By the age of 50, almost 50% of men will experience some degree of hair loss and one in four men will suffer some form of male pattern baldness (MPB), which has psychological, professional and social consequences for these men, such as:

• 68% of men feel helpless about their hair loss • 73% of balding men feel they are less attractive than they were when they had hair • 77% of balding men would feel very or somewhat concerned if they were in their 20’s, just starting their career and experiencing hair loss

Female Hair Loss Is On The Rise

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Hair loss in women is also extremely common. Studies show that in the U.S. alone, there are 40 million women who suffer from hair loss. The causes of hair loss in women are often due to genetics, but there are other causes such as hormonal changes, trauma, traction (braids, tight pony tails, etc.), sudden changes in diet, medical conditions such as thyroid problems, general anesthesia, and stress. Some studies suggest that a majority of premenopausal women and a greater number of postmenopausal women will experience some degree of diffuse hair thinning as part of the natural aging process. As a result, their hair loss is very gradual and often cyclical.

A medical exam, scalp biopsy and blood lab work may be required for the proper diagnosis of female hair loss.

For hair loss patients, there are prescription remedies, such as Propecia® (men only) and Rogaine® that offer some improvement to existing hair growth. However, surgical hair restoration is the only permanent solution for both men and women and one that can result in a natural, undetectable outcome.

The Robograft for Follicular Unit Extraction (FUE)

Other fields of medicine successfully use robotics for safe and effective surgical procedures such as heart valve and bypass surgeries, prostate surgery, and kidney transplantation. Now the technology is available for FUE hair restoration procedures. In recent years, FUE has gained greater popularity with patients looking for an even more minimally invasive approach to surgical hair restoration than the standard strip-excision harvest method. While it has always been considered less invasive than strip-excision procedures, manual FUE is a much more labor intensive procedure for the surgeon. Until now, the challenge has been that the surgeon spent a disproportionate amount of time extracting grafts from the donor area which left little time for the all-important overall artistic hair transplant design and creation of recipient sites to achieve the natural looking result that patient’s desire. The image-guided robotic arm, which is programmed with complex algorithms and sensors, enables the ARTAS System to bring great precision and speed in harvesting grafts at the ideal angle and direction, with the optimal distance between each extracted graft and at the proper depth of incision. This allows Dr. Ziering to focus on the artistic elements of creating natural age-appropriate hairlines and restoring a full head of hair for his patients who are battling hair loss.

With the Ziering Robotic Hair Transplants, a patient can expect: • A minimally invasive approach to extracting individual follicular units • No linear incision with a scalpel or linear scarring • Precise, consistent FUE harvesting • Nearly undetectable treatment after only one week to ten days • A quick return to regular daily activities • Hair can be worn at any length or style with confidence • Only permanent solution for hair loss

Superior Surgical Skills

As always, it still takes the unmatched surgical skill and artistic talent that is unique to Dr. Craig Ziering. His ability to create a natural, full looking head of hair is unsurpassed, and it’s no surprise that Ziering Worldwide is one of the first in the hair restoration industry to combine revolutionary medical science and aesthetic art into one.

The ARTAS System designed for Follicular Unit Extraction (FUE) and was used for the first time in California at Ziering Beverly Hills.

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Industry Transformer

Living In An Island Paradise Orthopedic Surgery Dr. Brian Bacot, M.D. In 2010 Brian Bacot, M.D. was one of the first orthopedic surgeons to arrive in earthquake ravaged Port-au-Prince to take care of residents injured during one of the most devastating earthquakes in history. It became a moment in time that changed Dr. Bacot’s life forever. His involvement with international healthcare services, including teaching local healthcare professionals in Costa Rica with the international organization Healthcare Volunteers Overseas was always gratifying to him. But there was something special and unique about helping to heal the people of Port-Au-Prince that inspired Dr. Bacot to deepen his commitment to medicine and to seek a new place to call home.

Dr. Bacot now owns and operates one of the most advanced orthopedic medical centers in the US Virgin Islands. With a focus on orthopedic surgery, sports medicine, tendon and joint repair and arthritis surgery, Dr. Bacot has practices on St. Croix and St. Thomas, and is enjoying living the life of an island doctor traveling by sea plane or private boat around the islands.

Prior to moving to St. Thomas, Dr. Bacot who is a fellowship-trained orthopedic surgeon and is well known for his highly developed skill in the treatment of arthritis, osteoporosis, trauma and other conditions, was the founder of a very successful practice in Atlanta, GA. With his pleasant and caring bedside manner, innovative, minimally invasive techniques, and emphasis on pain management – which all lead to rapid recovery and reduced pain – he became a surgeon of choice throughout the United States with a steady flow of patients who traveled from all over the world to see him. His philosophy of care towards his patients and his commitment to creating a physician-patient relationship that

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enhances recovery is what set him apart. Dr. Bacot came to realize, however, that his goal was not simply to run the race, but to set the standard and provide the best in orthopedic health care, something he felt he could do better from an island destination, rather than an urban environment.

Making friends and reaching out to people from all walks of life is what has brought Dr. Bacot well deserved success in the US Virgin Islands. Never shy to smile at a stranger, or offer a friendly word, Dr. Bacot now counts local farmers and politicians among his friends and patients.

“Relocating a practice is not as easy as it sounds,” Dr. Bacot reminisces. “But for me, in the long run, it’s definitely been worth all the hard work.”

“Being civic minded has always come naturally to me,” said Dr. Bacot. “Therefore, getting COG deeply and actively involved with local school activities, and sponsoring sporting events and teams, as well as contributing to many local charities, has become very important to me. ”

This year Dr. Bacot put the finishing touches to construction of Comprehensive Orthopaedic Global (COG), a new state-of-the-art medical center which is located on the island of St. Thomas in the Virgin Islands. COG offers patients a wide range of diagnostic and treatment services for conditions of the hip, knee, shoulder, foot, ankle and more, and houses a comprehensive radiology department with facilities for: X-rays, CT scans, Ultrasound, MRI, bone scans, and interventional radiology. COG also has its own surgical suite and is developing a multi-specialty outpatient surgical center.

It’s also helped spread the word about Comprehensive Orthopaedic Global which has a second office location on the island of St. Croix, and consulting offices on the island of St. John, as well as on Tortola, the Capital of the British Virgin Islands. Dr. Bacot’s regular commute to the office each day goes far beyond jumping into the car and getting stuck in freeway traffic. On any given day Dr. Bacot might be seen hopping onto a local

Industry Transformer

“My experience in Haiti showed me how important life really is, and how fleeting it can be,” said Dr. Bacot. “I felt a need to be in an environment where I could really contribute to the community and where, on my time off, I could nurture my own spirit.”

Sea Plane if going between offices on St. Croix and St. Thomas, to steering his own boat over to the islands of St. John or Tortola where he will travel through international waters and be asked to show a passport.

“My commute to work each day is varied and energizing to say the least,” laughed Dr. Bacot. “Varied because it could be by car, boat or plane, and energizing because I get to experience the true peace and beauty of the islands at different times of the day.”

If it sounds to you that it might take the stamina of an Olympic athlete to keep pace with Dr. Brian Bacot you might just be right.

Sports medicine is Bacot’s favorite area of work. A subspecialty of orthopedics, sports medicine deals with the prevention, diagnosis, treatment and rehabilitation of injuries suffered during athletic activity. The goal of treatment is to heal and rehabilitate the injury so patients can return to their favorite activities quickly, whether it’s Little League, recreational play or a high school, college or professional sport. Because of the frequent use, wear-and-

tear and risk of a fall or accident associated with sports activities, athletes are often susceptible to orthopedic injuries, including a stress fracture, chronic pain, or a tearing or stretching of internal structures. As with a sports team, there are many physicians who work together to help the patient regain maximum use of the injured limb or joint.

“Players” on the team are typically the physician, orthopedic surgeon, rehabilitation specialist, athletic trainer and physical therapist - and, of course, the patient,” explained Dr. Bacot. “I also have specialized training in the diagnosis, treatment and prevention of sports injuries, and can help athletes return to their favorite activities as quickly as possible through the most advanced, minimally invasive treatments available.” It is for this reason that Dr. Bacot is now joining forces with the Iron Man contest that runs on the island of St. Croix each year. Not that he’s hoping for anyone to sustain an injury, but if they do, he will be there on hand to give them the best orthopedic care.

So what’s next for Dr. Bacot?

“Well I have many ideas of ways to expand the practice in terms of branding, product development, more advanced physician communication and training opportunities and so on,” said Dr. Bacot. “But now that we have finished and perfected the COG Medical Center on St. Thomas, we will begin laying the stones for the new COG medical facility on St. Croix.”

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Industry Transformer

A Small

Slice Of Heaven

Dana Elise Solutions in Beverly Hills has been delivering exceptional skin care to Hollywood’s “who’s who” for almost 30 years. With signature treatments such as the Electro-Luxe Facial and the Hollywood Hair Line, Dana has garnered a great reputation among top dermatologists and plastic surgeons because of her depth of knowledge when it comes to skin health, and her understanding on how to keep skin optimal both Pre- and Post- Surgery. She is also known widely throughout the entertainment and film industry as the “go to” skin care expert at many red carpet events. As a leader in the art of skincare and the science of hair removal, as well as a carefully-chosen selection of other aesthetic services, Dana offers safe, effective solutions for troublesome skin, and a unique fusion of health, beauty and science in an all-inclusive approach that promotes inner health, outer beauty and greater self-confidence.

The Electro-Luxe Facial

The Elextro-Luxe Facial combines expertise in Skincare and Electrolysis. The two are brought together into one amazing skincare treatment that is non-invasive, pain free, thorough and results oriented. It begins with a double cleanse and a Diamond Tip Microdermabrasion to slough off dead skin cells. Then a Galvanic current (Anaphoresis) with Scaling Fluid produces a process called Saponification, which softens and opens the pores to prepare them for a deep clean and extractions. The true gift of this treatment is the application of Electrolysis, making this combination completely unique and effective. There are 3500 hairs per square inch and, as you can imagine, the follicles get clogged creating Acne, Mila (whiteheads) and blackheads. Dana’s expert hands steadily guide a sterile-micro-insulated probe into the existing follicle which applies a gentle current to heat the Mila, Acne or clogged follicle. The heat of the current sterilizes the base of the follicle and reduces bacteria. The skin is then gently cleansed once more and a second Galvanic current, this time with positive pole energy called Cataphoresis, is used to deliver Hyaluronic Serum into the skin for complete hydration and to close the pores. Finally the use of High Frequency, a germicidal technique that rids the skin of any remaining bacteria, is applied across the entire face, and the use of LED light therapy for varying skin conditions is available. Now for the luxury…… massage of the décolleté, shoulders, forearms and hands for complete upper body relaxation and hydration… this is when we say, “Please don’t make me get up -this is a little slice of heaven!”

Hollywood Hairlines for Men & Women

Skincare for Pre and Post Facial Surgery

Hairline help is not necessarily just about natural hair loss and balding. Some people may have too much hair in areas of their face and body that they would prefer not to have, while others lose hair as a result of hormones and natural occurrences, injury or surgery. Dana Elise has been restoring a natural side burn hairline and helping many men after facial-lift surgery where the beard hair has been pulled behind the ear.

Dana works closely with many Plastic Surgeons, Endocrinologists and Dermatologists on other interesting and demanding cases -- women that suffer Polycystic Ovaries (PCOS) and excessive hair growth from the imbalance of female hormones have gone to Dana for help.

She also works closely with the Transgendered community in the removal of entire beards through Accelerated Electrology, where two Electrologists work simultaneously to clear an entire area, head to toe, beards, backs and bikinis. Even unsightly Ear Hair does not stand a chance with Dana around. With a team of professional and seasoned Electrologists, their expertise results in Hairless Bliss!

Glowing, youthful skin is a must have in Hollywood and beyond, and Dana Elise and her team of Estheticians have tailored several skincare treatments with IS Clinical, Specialty Peels, O2 Oxygen Facials and Cosmelan Peels specifically for people of color and clients with hydrating needs, as well as other specialty treatments to get their skin into fantastic shape prior to facial surgery. Many patients have the need for microdermabrasion, extractions, hydration, and correction of discoloration or Hyperpigmentation that needs to be attended to before and after surgery. If a clients is having a Rhinoplasty for example, and has blackheads that need removal, this must be done prior to surgery as you will not want to disturb or press against the nose for 6 months to a year after surgery. Dana works closely with surgeons to prepare the skin prior to cosmetic surgery so that the overall appearance is youthful, refreshed and even toned.

Dana Elise Solutions offers each skin care client a thorough and detailed private consultation, and develops a custom program designed with home care products for ultimate effective results. Dana believes in beauty from the inside out and looking and feeling your best. A True Fusion of Health, Beauty and Science.

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Delivering exceptional skin care to Hollywood’s “who’s who” for almost 30 years. before

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Beauty & Grooming Grooming options for men are finally catching up with the many options the ladies have. The daily ritual of face shaving is finally getting the attention it deserves. Our male doctors tell us it’s more than just foam, razor, and the face; there are oils, creams, gels and moisturizers. Having the right shaving products leaves a doctor ready to seize the day so BIG Medicine Magazine’s™ crack investigative team delved right into the steamy world of shaving. We found that the key to avoiding discomfort starts by looking at the ingredients, if alcohol is one of the main ones…run. Also, foam is the shameful shaving secret of the past that no one should admit to.

Shaving Tips: 1. Pre Shave: Are you using Shaving Oils?

2. DO NOT USE A DULL RAZOR! 3. Shave along the grain. For an extra clean shave reapply the shaving cream and you can go against the grain, but this shouldn’t be necessary if you used shaving oil.

4. NO heavy lather! Stick to a cream or gel that doesn’t lather heavily. Heavy lather creates resistance to the blade which leads to razor burn, ingrown hairs, bumps and redness.

5. After Shave: Since you were a wee lad, your father explained the need for aftershave yet for some reason we always picture the scene of Kevin McCallister (played by McCauley Culkin in Home Alone) shrieking like a banshee. Surprising tip about aftershave we discovered, you don’t need it.

BIG Medicine Magazine™ Picks Oils: The secret weapon for a smooth, clean shave is shaving oil. Apply a few drops, wait and then apply shaving cream or gel. Oil can also be used alone.

• American Crew Essential Shave Oil: Helps soften the beard for a faster, closer shave.

Creams soften and lift up whiskers and provide a lubricated path for razors to flow through.

• Kiehl’s Ultimate Brushless Shave Cream: The best results for the least effort.

Gels are the BIG Medicine Magazine™ favorite if you have sensitive skin and/or manicured facial hair.

• Dermalogica Invigorating Shave Gel: It’s an oil free gel, clear texture and a little goes a long way.

Working Hands Like most doctors, you wash your hands before the consult and after the consult, before surgery and after surgery, before injection and after injection.

YOU WASH YOUR HANDS A LOT. If you are seeing 20 patients in your day, that’s a minimum of 40 hand washings which is extremely harsh on your skin.

BIG Medicine Magazine™ asked 50 doctors what their favorite hand cream after a busy day in the office was.

This is how they voted: 38% Eucerin Hand Cream 20% Kiehl’s Ultimate Strength Hand Salve

Hollywood Skin Keeping a Hollywood Glow means no flaky skin and experts recommend exfoliating at least once a week. BIG Medicine Magazine™ tested several leading skin exfoliators and loved every one of them.

Best Every Day Skin Cleanser • Chella Exfoliating Cleanser Micro Bead Purifier It’s name tells us everything we need to know about this exfoliator, it cleanses, it exfoliates, it has micro beads and your skin definitely ends up feeling PURE. Made for challenged skin, this everyday cleanser clears with gentle jojoba beads, so time-released salicylic acid can equalize oil and counter acne causing bacteria all day long. The fresh cucumber peel fragrance appeals to your sense of well-being. A small drop goes a long way which makes it a good buy.

19% Lab Series For Men Active Hand Cream 12% Anthony: Sport Healing Hand Cream 11% Bliss High Intensity Hand Cream

Best Bi-Weekly Exfoliator • Boscia Smoothing Facial Polish This smoothing facial exfoliator contains natural Mannan granules. While gently polishing away dull, dead skin, willow herb calms any irritation to reveal a fresher, vibrant complexion. Medicinal Carbon absorbs deep dirt and oil while Jujube Fruit promotes circulation and accelerates skin cell regeneration for a younger looking appearance.

Althaea Root and Jojoba Leaf, a powerful antioxidant, hydrate skin and help protect against free radical damage.

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Finally,

a lasting, non-invasive solution for underarm sweat.

Problem: 1 in 5 people are bothered by their underarm sweat. For these people, sweat is a daily struggle, and interferes with everyday life.

miraDry Solution: • The only treatment option that is FDA-cleared to provide lasting results • Uses non-invasive technology • Little to no patient downtime

Find out more today www.miraDry.com 1-855-miraDry

©2013 Miramar Labs, Inc. All rights reserved. miraDry is a registered trademarks of Miramar Labs, Inc. MK0082.C 1/13

How To Say QUESO! Smile For The Camera “Are you ready for your close-up?” said Cecil B. Demille to Norma Desmond aka Gloria Swanson in the famous Hollywood classic movie Sunset Boulevard. Of course she was ready. She had prepared for hours, even her whole life, for this moment. But taking a great picture can require more than hours of preparation. Finding somebody who can handle a camera is imperative to the outcome of your headshot. BIG Medicine Magazine™ asked photographer Mehri Modini, for some tips.

How do you see yourself? Successful? Strong? Interesting? Credible?

Now, how do others see you? Driven? Responsible? Cutting Edge? Trustworthy?

ARE YOU SURE? We’ve all heard that a first impression lasts a lifetime. As a medical professional you strive to be on the top of your game constantly and should know that first “meeting” you have with a patient (or anyone) is a make or break moment. But in this world of viral technology, is that meeting their ‘first” impression of you? Or has someone already “sized” you up before you’ve ever set eyes on them…. because they have seen you in web site and social media photos.

Enter the age of the fabulous headshot. In today’s on-line world, it is even more important for everyone, especially medical professionals, to put their best face forward. More than just a “pretty face”, an outstanding headshot can showcase your positive attributes and, most importantly, leave a lasting impression so you are remembered well. But taking a terrific headshot is not as easy as it looks! We all know a picture is worth a thousand words, (hopefully not a thousand ‘notso-good words’).

Here are critical planning tips to make sure your headshot is spectacular: •

is pretty obvious but if you had to pull an allnighter, this just isn’t happening….reschedule •

make you look overly tired •

Don’t have a facial or skin treatment the day before a shoot, but do use a scrub, mask or light exfoliator the night before and apply night time moisturizer

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Bring a wardrobe for the photographer to choose from and, better yet, if possible find someone who can tell you what colors flatter your face. Or hire a stylist

Second, look at headshots. Did the photograph stir your emotions? Do you have a warm, giddy feeling inside to meet this person or just….next?

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Finally, notice the unique. Did the photographer take the time to really highlight your uniqueness…. which may not necessary be your face, but the pose, lighting, any props…etc.

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Once you’ve found that special photographer with an “eye” for you, put your best face forward.

No alcohol the night before a big shoot. It bloats your face, dehydrates you and can

So how do you find a photographer as fabulous as you?

First, look to the stars. In the entertainment world, an awesome headshot is beyond critical. For them, the headshot IS the first impression and with the intense competition, it better be knock-down, dragout, fantastic!

Get a good night’s sleep. You might think this

Leave the giant jewelry for Mr. T, just pick simple pieces that don’t take away from the real you If possible, have your make-up and hair professionally done…and yes, the men too

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Determine if any props would make sense depending on your specialty

An amazing headshot is only the start of a lasting first impression you will develop with your patients or clients, but in today’s world of on-line marketing it is one of the most valuable items in your toolbox.

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Remember: Good Enough is NOT Good Enough for YOU!

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Don’t rush your appointment. Make sure your schedule is open so that you can relax and enjoy the moment Get your mojo on! Walk in and be ready to have fun and let the camera capture the spirit of you

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“A great friendly headshot of YOU in your marketing materials is vital.”

Relax; remember as a professional your headshot should wreak of credibility

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Lights, Camera, Help.....!!

What YOU Can Learn From A Real Housewife!

Most doctors and medical professionals spend their time and energy caring for patients and perfecting their skills, not perfecting themselves for the spotlight of a camera. Now, however, with the growth of reality TV shows, video presentations on YouTube and the world of HDTV – using High Definition Cameras - the lens is bound to end up pointed at you and you need to be ready. BIG Medicine Magazine™ asked leading hair stylist and make-up artist Coby Knight, who recently worked on The Real Housewife television show franchise, for tips on how to look great, without looking fake.

Hair and make-up – male and female – has never been as important as it is today, especially for those doctors that spend any amount of time in front of the camera, be it on a TV show, or videos on-line highlighting their practice. They say the camera does not lie. And with the new version of High Definition TV, many of my clients feel that the camera gets a little too ‘up close and personal’. As a hair stylist and makeup artist in the Orange County and Los Angeles areas for the last 18 years I have been able to help many people look and feel their best in front of the camera. Whether you are a model, a bride or a doctor, the quality of your hair and skin on camera is important. Recently working with the cast of The Real Housewives of Orange County, I had the opportunity to work with the leading cast members, as well as the many guests, including doctors, that made the show.

I would like to share with you a few simple pointers that can prepare you for your close up.

Tips For Women: Foundation and concealer should be HD Makeup. HD Makeup reflects the lights and creates a smooth surface for the magnification of the HD Cameras. HD Makeup can be found at Sephora or Ulta stores.

Choose one feature that you want to accentuate - usually eyes are a good choice because they show a lot of expression on camera. Wearing too much makeup, or attempting to accentuate all of your facial features (eyes, lips, cheeks, and brows) can give you a clownish appearance.

Apply individual fake eyelash sections to outer corners of lashes to make your eyes “pop” a little. This will be very subtle, but will make a BIG difference on screen.

Hair should look clean and simple. If you have bangs or layers around your face make sure they are slightly pulled back or swept to the side… if bangs/hair are hanging over your eyes, it will create a shadow and could be distracting.

Don’t wear too much lip gloss. A little neutral color (light peachy pink) with a little shine is good. Too much shimmer or high gloss will be magnified on camera.

Tips For Men: Using a small amount of HD Makeup (foundation or concealer) applied with a brush or a sponge to areas where you have dark spots or imperfections will work well for you. Remember the HD lens will show everything and magnify things even more.

However, when it comes to makeup on men, remember less is more.

Make sure your hair is clean and simple. Do not use too much hairspray or gel as it can look shiny or stiff on camera.

While I don’t encourage men to wear lipstick (or false eyelashes), a little Chapstick can go a long way. The cherry Chapstick brand works wonders as it moisturizes the lips and has a hint of color that will make your lips look soft and healthy.

A smile goes a long way. Check your teeth up close. Make sure they are clean, flossed and that your gums look healthy. If necessary, there are some good over-the-counter bleaching products that can give you a quick Hollywood Smile!

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BIG Medicine Magazine™

POWER SHOTS!

Is Your Body Language Holding You Back?

Model: Brandon Murphy Barnes

What message are you sending with your body language? According to research performed by Harvard Business School professor Amy Cuddy, with body language we can change a person’s perception of us – and our own body chemistry - simply by changing body positions. Amy Cuddy gave a great talk available on the popular website TED (www.TED.com) about how small changes in your body language can radically change your job performance and career. Certain “power poses” immediately change your body chemistry, Professor Cuddy says. “And these changes help or hurt the way other people perceive you and, importantly, affect the way you actually perform. The full video is 21 minutes long and definitely worth watching.

Superman Pose

Game Changer Pose

Relaxed Power Pose

High Power Pose

Pride Pose

Relaxed Control Pose BIG Medicine Magazine™

35

Voted Best Sunscreen www.bluelizard.net 800.334.4286

Contributors

American Crew www.americancrew.com

J. David Holcomb, M.D. www.srqfps.com

Anthony Brands www.anthony.com

Kedy Jao. D.O. www.doctorjao.com

Association of Certified Fraud Examiners www.acfe.com

Vishal Kapoor, M.D. www.drkapoormd.com

Lancaster Adams www.sbpra.com/lancasteradams

Kiehl’s www.kiehls.com

Brian Bacot, M.D. www.cogvi.com

Coby Knight www.cobysclips.com

Blissworld www.blissworld.com

Russell Kridel, M.D. www.todaysface.com

Blue Lizard www.bluelizard.com

Lab Series www.labseries.com

Boscia www.bosciaskincare.com

Harrison Lee, M.D. www.drharrisonlee.com

Gregory Buford, M.D. www.beautybybuford.com

Lutronic www.lutronic.com

Juris Bunkis, M.D. www.ocps.com

Toby Mayer, M.D. www.bevhills.com

Chella www.chella.com

Mehri Modini www.mehriphotographyla.com

Lavinia Chong, M.D. www.chongmd.com

miraDry www.miraDry.com

Herb Cohen www.fiduciaryplus.com

Brent Moelleken, M.D. www.drbrent.com

Professional Fiduciary Association of California www.pfac-pro.org

Sam Muslin, D.D.S www.faceliftdentistry.com

Stephen Covey www.stephencovey.com

Joe Niamtu, III, D.M.D. www.lovethatface.com

Amy Cuddy www.TED.com

F.R. Noodleman, M.D. www.agedefy.com

Dana Elise www.danaelisesolutions.com

Angela O’Mara www.theprofessionalimage.com

Marcel Daniels, M.D. www.imagemd.com

Oxygenetix www.oxygenetix.com

John Davidson www.highlevelperformance.com

Steven Pearlman, M.D. www.mdface.com

Dermalogica USA www.dermalogica.com

Giles Raines www.theprofessionalimage.com

Eucerin www.eucerin.com

Kevin Sadati, M.D. www.galleryofcosmeticsurgery.com

Richard Fleming, M.D. www.bevhills.com

John Shieh, M.D. www.rejuvayou.com

Andrew Frankel, M.D. www.rhinoplastyrevisions.com

Michael Will, DDS, M.D. www.willsurgicalarts.com

Implantech www.implantech.com

Craig Ziering, M.D. www.zieringmedical.com

If you want to become a contributor to BIG Medicine Magazine™, or if there is a medical topic you would like to see covered in this magazine, send your ideas to: storyideas@bigmedicinemagazine.com.

BIG Medicine Magazine™

37

A Final Word

When TV Goes Bad!

Let’s Hear It From Giles Raine

“America’s FAVORITE PUBLICIST”

As a publicist, I frequently watch TV

More advertising revenue equals fatte

In general, a good rule of thumb is; if

shows or read news stories that have

paychecks for the media executives. The

the producer or reporter is asking you for

only

the

same goes for “New Pilot Season”. If a new

anything that seems to be sensational,

person who connected the production

“Pilot” show can garner vast numbers of

rather than plain old dramatic, for the

company, producer or journalist with an

viewers, the more likely the networks will sign

benefit of telling your story, that is a warning

expert who had a story to tell. Helping

up for more production of that particular

sign of TV Going Bad.

our clients become influential news and

show. Why? Because they can show

opinion resources for the media doesn’t

advertisers the ratings for that segment and

just automatically happen. Guiding them

persuade them to advertise around future

through the maze of great TV and other

shows. Again, more MONEY goes to the

media opportunities that will help them

executive production team.

happened

because

I

was

build their reputation and increase their patient/client base, while keeping them away from other situations that could potentially be harmful to their brand, is a skill that takes many years and experience to develop.

One of the most exciting times of the media year is always “Sweeps” and the “New Pilot Season”. This year, I have to say, there are some TV shows now on air that I would definitely discourage any of my doctor clients from being a part of, and

What

this

brings

together

Even though you may not have any media experience, if your gut feeling tells you that the media opportunity is asking you to respond or participate in a manner that you would not normally feel appropriate …

are

two

completely different agendas on the part of the physician being interviewed and the media production team creating the segment or show. Even when you are working with a producer or reporter that you have had a good past experience with, how do you know if their agenda is to report accurately and conservatively, or if it has changed and has become more sensational and ratings driven?

this is TV Going Bad. When other guests or talent on a show are so extreme that it feels like a freak show … this is TV Going Bad. Hiring

an

experienced

professional

publicist is certainly one way to make sure that you get the best out of your media opportunities. If you do not have a publicist, then I recommend the book Lights! Camera! Action! The POWER of PR (order at www.theprofessionalimage.com)

there are some new shows airing that I am

as a great overall guide to understanding

proud to say my clients have top rating.

the media. After all, you have worked

However, many people are of the opinion

hard to build your reputation as a doctor,

that placing a doctor in the news is as

you don’t want one to find yourself as part

simple as pushing a button. But after years

of the cast of TV Going Bad.

of doing what I call “wrangling media,” by placing a good story in the news or a client on a major TV show, is not as easy as it looks. Much of this issue of BIG Medicine Magazine™ features articles on business building, success and that dirty little word, MONEY. Media is all about MONEY. So let’s talk a little about “Sweeps” and the “New Pilot Season” and MONEY. “Sweeps” is that time of year when TV shows are being rated on the size of their audience. The bigger the audience, the more popular the show becomes, equals higher advertising revenues for the station or network.

38

BIG Medicine Magazine™

Past issue contributers to BIG Medicine Magazine™ attorney Rick Lundblade and Beverly Hills Therapist Carla Lundblade with Giles Raine at a celebration dinner in Newport Beach, CA.

As a medical media specialist, Giles is an expert in explaining complex scientific and medical concepts that will enable producers and editors to accurately and clearly “tell your story” to readers and viewers nationwide. With over 30 years of PR and Branding experience Giles knows how to give the media what they need to produce a great show, interview or news story, has made him an important resource for many producers, writers and editors worldwide.

The Professional Image, Inc.

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